Choledocholithiasis—principles of diagnosis and management

Lahmann, Brian; Adrales, Gina L.; Schwartz, Richard W.

doi:10.1016/j.cursur.2003.07.014

Cited by 20 publications

(20 citation statements)

References 16 publications

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“…Pain is often situated in the right hypochondrium or epigastrium and can last from 30 minutes to several hours, with associated symptoms such as nausea and vomiting [10]. Other common symptoms include pale stools and dark-colored urine, which can be elicited in the patient history by a thorough review of systems [12]. Two serious complications of CBDS are cholangitis and gallstone pancreatitis.…”

Section: Pathogenesis and Clinical Manifestationmentioning

confidence: 99%

“…Patients exhibiting the described symptoms require diagnostic investigation to assess for the presence of CBDS [12]. Liver function tests (LFTs) can be used to screen for CBDS [20, 21].…”

Section: Assessment and Diagnosismentioning

confidence: 99%

“…Endoscopic retrograde cholangiopancreatography (ERCP) is often described as the gold standard test to for the detection of CBDS [10]. This procedure was initially used primarily in diagnosis, but today is more commonly used as a therapeutic modality [12]. ERCP has sensitivity between 90% to 95% in detecting CBD stones [30, 31] and a specificity of 92% to 98% [32, 33].…”

Section: Assessment and Diagnosismentioning

confidence: 99%

“…EUS is significantly more sensitive than TUS in detecting CBD stones. Its sensitivity is comparable to the diagnostic ERCP, while its major advantage is a significantly decreased morbidity compared to ERCP [12, 37]. The EUS exam is a noninvasive test, with excellent overall sensitivity and specificity for diagnosing choledocholithiasis, but it is highly dependent on the examiner.…”

Section: Assessment and Diagnosismentioning

confidence: 99%

See 3 more Smart Citations

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Shojaiefard

Esmaeilzadeh

Ghafouri

et al. 2009

Gastroenterology Research and Practice

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Common bile duct stones (CBDSs) may occur in up to 3%–14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.

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Section: Pathogenesis and Clinical Manifestationmentioning

confidence: 99%

“…Patients exhibiting the described symptoms require diagnostic investigation to assess for the presence of CBDS [12]. Liver function tests (LFTs) can be used to screen for CBDS [20, 21].…”

Section: Assessment and Diagnosismentioning

confidence: 99%

Section: Assessment and Diagnosismentioning

confidence: 99%

Section: Assessment and Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Shojaiefard

Esmaeilzadeh

Ghafouri

et al. 2009

Gastroenterology Research and Practice

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“…The choice of the best strategy is often led by the local presence of professional expertise and resources, rather than by a real superiority of one strategy over another [12,[14][15][16][17][18] . However, the current standard of treatment for CCL is influenced by many different professionals, including gastroenterologists, anesthesiologists, surgeons and endoscopists, leading to some conflict regarding organizing approaches for treatment.…”

Section: Introductionmentioning

confidence: 99%

Modern approach to cholecysto-choledocholithiasis

Bencini¹

2014

WJGE

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Gallstones and common bile duct calculi are found to be associated in 8%-20% of patients, leading to possible life-threatening complications, such as acute biliary pancreatitis, jaundice and cholangitis. The gold standard of care for gallbladder calculi and isolated common bile duct stones is represented by laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography, respectively, while a debate still exists regarding how to treat the two diseases at the same time. Many therapeutic options are also available when the two conditions are associated, including many different types of treatment, which local professionals often administer. The need to limit maximum discomfort and risks for the patients, combined with the economic pressure of reducing costs and utilizing resources, favors single-step procedures. However, a multitude of data fail to strongly demonstrate the superiority of any technique (including a two or multi-step approach), while rigorous clinical trials that include so many different types of treatment are still lacking, and it is most likely unrealistic to conduct them in the future. Therefore, the choice of the best management is often led by the local presence of professional expertise and resources, rather than by a real superiority of one strategy over another.

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Giant Primary Choledocholithiasis: A Rare Case Report and Comprehensive Review of Literature

Lamichhane,

KC,

Mishra

et al. 2024

Clinical Case Reports

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Choledocholithiasis is the second most common complication of gallstone disease. Giant primary choledocholithiasis is a rare occurrence. Ultrasonography is the initial mode of imaging, and endoscopic ultrasound is considered superior to other modalities. Endoscopic retrograde cholangiopancreatography can be used for stone extraction. Other treatment modalities include laparoscopic or open common bile duct (CBD) exploration. Many institutions in underdeveloped countries still practice open CBD exploration. Factors such as larger stone diameter, edema of the CBD, and the presence of multiple lithiasis can influence the treatment approach. In this article we are presenting a case of 62 years‐old‐female with no any known comorbidities had presented to emergency with severe upper quadrant pain and giant choledocholithiasis was diagnosed in ultrasound and computed tomography scan with no other features of complications and patient successfully underwent open CBD exploration with intraoperative choledochoscopy and primary closure.

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Choledocholithiasis—principles of diagnosis and management

Cited by 20 publications

References 16 publications

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Modern approach to cholecysto-choledocholithiasis

Giant Primary Choledocholithiasis: A Rare Case Report and Comprehensive Review of Literature

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